Table 2. Virologic tests performed on patient specimens*†.
| Virus | CSF | Brain | Liver | Spleen | Kidney | Lung | Heart | Diagnostic methods | Tested before death? |
|---|---|---|---|---|---|---|---|---|---|
| HSV (PCR) | – | – | – | ND | – | – | – | In-house PCR (nested), cell culture | Yes (from CSF and brain biopsy) |
| VZV (PCR) | – | – | ND | ND | ND | – | ND | In-house PCR (nested), cell culture | Yes (from CSF and brain biopsy) |
| Adenovirus (PCR) | – | – | – | – | – | – | In-house PCR (nested) | – | |
| HHV-6 (PCR) | – | – | – | – | – | – | In-house PCR (nested) | – | |
| HBV (PCR) | – | – | – | – | – | – | In-house PCR (nested) | – | |
| HCV (PCR) | – | – | – | – | – | – | In-house PCR (nested) | – | |
| ParvoB19 (PCR) | – | – | – | – | – | – | In-house PCR (nested) | – | |
| CMV (PCR) | – | – | – | – | – | – | In-house PCR (nested), cell culture | – | |
| Enterovirus (PCR) | – | – | – | ND | – | – | In-house RT-PCR, cell culture | – | |
| RSV (Antigen) | ND | ND | ND | ND | – | ND | Antigen ELISA, Directigen RSV (Becton Dickinison, Heidelberg, Germany) | – | |
| RSV (cell culture) | – | – | – | – | – | – | Cell culture | – | |
| Influenza A+B | – | – | – | – | – | – | Cell culture | – | |
| Mumps | – | – | – | – | – | – | Cell culture | Measles excluded, no symptoms of mumps† | |
| Measles | – | – | – | – | – | – | Cell culture | ||
| HMPV (PCR) | – | + | ND | ND | ND | + | ND | In-house RT-PCR (5,13) | – |
| HMPV (PCR from cell culture supernatant) | – | + | ND | ND | ND | + | ND | In-house RT-PCR (5,13) from Vero-cell culture supernatant | – |
*CSF, cerebrospinal fluid; HSV, herpes simplex virus; PCR, polymerase chain reaction; ND, not done; VZV, varicella–zoster virus; HHV, human herpesvirus; HBV, hepatitis B virus; HCV, hepatitis C virus; CMV, cytomegalovirus; RT, reverse transcriptase; RSV, respiratory syncytial virus; ELISA, enzyme-linked immunosorbent assay; HMPV, human metapneumovirus. †Before death, viral encephalitis induced by HSV and VZV was excluded by nested PCR from the CSF and also from a biopsy. Measles and mumps were excluded by the primary anamnestic protocol (no exanthema or other clinical symptoms). The anamnestic protocol also showed a successful vaccination against those pathogens. Furthermore, no clinical symptoms of mumps were observed. Postmortem specimens from brain, lung, kidney, liver, spleen, and heart were mounted on different cell lines. Detailed PCR protocols are available on request.